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Pediatric Bone and Joint infection Treatment, Surgery

The treatment and surgery that may be right for your child’s pediatric bone and joint infection depends on a variety of factors, which include their age, current and past health, the severity of the infection and their history with various medications and treatments. Pediatric bone and joint infections are a result of bacteria in our daily environment that get into the blood stream and affect the musculoskeletal system.

Pediatric Bone and Joint Infection Diagnosis

A pediatric bone and joint infection can significantly affect your child’s development and quickly spread to other areas of the body. If you think your child might have a bone or joint infection, it is important to seek medical attention quickly to avoid the spread or worsening of this condition. To diagnose the condition, the doctor will start out by asking a series of questions and doing a brief physical exam. To further understand the nature of the condition, the doctor will ask for at least one of these tests:

Blood Tests – Because these conditions come from bacteria spread by the blood stream, it will be important to test the blood to determine the type of bacteria that may have made it into the bone or joint.

Tissue Culture – Tissue may also be taken from the area of the infection to try to gain more information on the specifics of the infection.

X-Ray (Radiograph) – A radiograph gives the doctor an overview of the extent of the damage from the infection, and allows for more sound decisions as far as what treatment is required.

Ultrasound – This test provides the doctor with information on the tissue and fluids in the infected joint that will also help determine the best treatment solution.

Nonsurgical Treatment for Pediatric Bone and Joint Infections
Depending on the infection and the age of the child, some pediatric bone and joint infections can be treated with antibiotics. The child will continue to have to be watched over time as the antibiotics work to ensure the infection does not become any worse. Because early detection is so important to the health of the bones and joints, it is important that infections are closely monitored for signs of worsening. For this reason, the child may be hospitalized while the antibiotics are being administered. They may also receive pain medication to help ease symptoms. Antibiotics are the most common form of treatment for young children aged 2 to 5.

Surgery for Pediatric Bone and Joint Infections

In many cases, pediatric bone and joint infections require surgery to remove the affected skin, bone and tissue. The following are some of the treatments used:

Removal of Infected Tissue – The infected tissue will need to be removed from the joint and bone. If there are significant spaces left where the tissue was removed, a bone graft may need to be added to encourage regrowth of healthy bone.

Needle Drainage – The fluid around the site will need to be drained in the case of a pediatric bone and joint infection. This requires surgery to ensure all fluid is drained from deep inside the joint area. In many cases, this can be done using a needle aspiration.

Arthroscopic Drainage – When needle drainage does not work, a scope is put into the joint to help extract the fluids. This is most commonly performed in knee infections.

Metaphyseal Drainage – For larger joints, such as the hip and shoulder, the chances of the infection spreading are greater. Because of this, a larger incision is needed to extract the infected fluid and ensure none is missed.

Pediatric Bone and Joint Infection Research
The majority of the research surrounding pediatric bone and joint infections has to do with managing and treating the infection properly so it does not return and there are no complications. In many communities, the emergence of methicillin-resistant Staphylococcus aureus (MRSA) has been seen. This specific type of infection does not respond to most antibiotics and has been linked to serious illness and even death in children.

Minor cases that are caught early and are not at a mature stage can be effectively managed through antibiotics, such as penicillin. More research is being done to determine the best approach to handle multifocal infections in children.

In communities where MRSA is prevalent, other treatment methods are being researched to try to determine how to respond to this specific type of bacteria. MRSA is thought to cost hospitals billions of dollars each year. As a rise of this infection is seen, so is a rise in the cost to hospitals. Infection rates have increased to as high as 60% in emergency rooms, making the need to control this penicillin-resistant infection even more necessary. Some newer forms of antibiotics, such as linezolid, have been used to treat MRSA. However, when it comes to the delicate cases of pediatric bone and joint infections, there is still a lot of work to be done to properly treat these diseases without creating a negative reaction in children’s growing bodies.

As research on pediatric bone and joint infections is ongoing, it is a good idea for your conversation about it with your doctor to be ongoing as well.

Rehabilitation Services
The Rehabilitation Network of the North Shore-LIJ Health System is dedicated to providing you and your family with result-oriented, comprehensive rehabilitation services. Our goal is to help you and your loved ones find relief from pain and get moving again after an accident, illness, injury or surgery. We’re your partner in a safe, healthy, more rapid recovery.

The multidisciplinary team of orthopaedic experts at North Shore-LIJ Orthopaedic Institute in New York performs Pediatric Bone and Joint Infections surgery as well as a broad range of nonsurgical and surgical treatments for conditions that affect the bones.